Background: Tackling severe acute malnutrition (SAM) is a global health priority. Whilst SAM-related mortality is well described, little is known about long-term effects on survivors. Given extensive evidence from developed countries that early nutritional insults have enduring detrimental effects, particularly heightened risk of non-communicable disease (NCD) in adulthood, it is plausible that SAM survivors could share some of these traits. Applying the DOHaD (Developmental Origins of Health an...more

Background:The prevalence of stunting, thinness, overweight, and obesity among children differs by ethnicity. It is not known whether differences in body build across the ethnic groups influence the interpretation of nutritional parameters.Objective:To explore the differences in body build across the 5 main ethnic groups in Malaysia and to determine whether differences in body build have an impact on the interpretation of nutrition indicators.Methods:A total of 3227 children aged 2.0 to 12.9 yea...more

Background Low birth weight and unhealthy lifestyles in adulthood have been independently associated with an elevated risk of hypertension. However, no study has examined the joint effects of these factors on incidence of hypertension.

Abstract Background and aims Whereas adult weight or body mass index (BMI) are directly associated with blood pressure (BP), birth weight is inversely associated with BP. The scenario for height is more complex, as both tall and short stature have been associated with higher BP. We used a theoretical model treating sitting height (SH) and tissue masses (fat mass, lean mass) as components of metabolic load, and leg length (LL) as a marker of homeostatic metabolic capacity. We predicted that decre...more

This paper is a narrative review of the available literature on the relationship between wasting and stunting. It was born out of previous work carried out by the ENN which illustrated the divide at programme, policy and financing level between wasting and stunting. This divide ultimately has profound implications for how children worldwide receive nutrition interventions and services and, may well contribute to the lack of nutritional impact seen in programmes only addressing one part of the u...more

BACKGROUND: A growing literature has linked early childhood growth to later-life cognition and schooling outcomes in developing countries. Although existing evidence suggests that children's ability to recover from early growth delays in later childhood is limited, longitudinal studies on the persistence and risk of growth faltering beyond age 5 y remain scarce. OBJECTIVE: Using longitudinal data recently collected from 4 developing countries as part of the Young Lives study, we investigated cat...more

Background: Management of Severe Acute Malnutrition (SAM) plays a vital role in achieving global child survival targets. Effective treatment programmes are available but little is known about longer term outcomes following programme discharge. Methods: From July 2006 to March 2007, 1024 children (median age 21.5 months, IQR 15-32) contributed 1187 admission episodes to an inpatient-based SAM treatment centre in Blantyre, Malawi. Long term outcomes, were determined in a longitudinal cohort study,...more

An analysis of early growth patterns in children from 54 resource-poor countries in Africa and Southeast Asia shows a rapid falloff in the height-for-age z score during the first 2 y of life and no recovery until $5 y of age. This finding has focused attention on the period 2 9t o 24 mo as a window of opportunity for interventions against stunting and has garnered considerable political backing for investment targeted at the first 1000 d. These important initiatives should not be undermined, but...more

The monitoring and combined use of dietary supplements to restore adequate growth are paramount and highly recommended in child malnutrition, an important public health problem. The objective of this study was to analyze the effects of cashew nut seed flour in children with moderate malnutrition, treated at primary healthcare services. This is a randomized clinical trial conducted from April to October 2017 in the city of Imperatriz, Brazil. The sample comprised 30 children born at term, aged be...more

Each year, acute malnutrition affects an estimated 52 million children under 5 years of age. Current global treatment protocols divide treatment of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) despite malnutrition being a spectrum disease. A proposed Combined Protocol provides for (a) treatment of MAM and SAM at the same location; (b) diagnosis using middle-upper-arm circumference (MUAC) and oedema only; (c) treatment using a single product, ready-to-use-therapeutic food...more

Hospital readmission is common among children with complicated severe acute malnutrition (cSAM) but not well-characterised. Two distinct cSAM phenotypes, marasmus and kwashiorkor, exist, but their pathophysiology and whether the same phenotype persists at relapse are unclear. We aimed to test the association between cSAM phenotype at index admission and readmission following recovery. We performed secondary data analysis from a multicentre randomised trial in Kenya with 1-year active follow-up. ...more

BACKGROUND: It is well documented that treatment for severe acute malnutrition (SAM) is effective. However, little is known about the long-term outcomes for children treated for SAM. We sought to trace former SAM patients 11 to 30 years after their discharge from hospital, and to describe their longer-term survival and their growth to adulthood. METHODS: A total of 1,981 records of subjects admitted for SAM between 1988 and 2007 were taken from the archives of Lwiro hospital, in South Kivu, DRC....more

Summary Background & aims Treatment of children with uncomplicated severe acute malnutrition (SAM) is based on ready-to-use therapeutic foods (RUTF) prescribed based on body weight and administered at home. Treatment performance is typically monitored through weight gain. We previously reported that a reduced dose of RUTF resulted in weight gain velocity similar to standard dose. Here we investigate the change in body composition of children treated for SAM and compare it to community controls, ...more

Summary Malnutrition has historically been researched and addressed within two distinct silos, focusing either on undernutrition, food insecurity, and micronutrient deficiencies, or on overweight, obesity, and dietary excess. However, through rapid global nutrition transition, an increasing proportion of individuals are exposed to different forms of malnutrition during the life course and have the double burden of malnutrition (DBM) directly. Long-lasting effects of malnutrition in early life ca...more

Until recently, undernourished children were usually assessed using simple anthropometric measurements, which provide global assessments of nutritional status. There is increasing interest in obtaining more direct data on body composition to assess the effects of undernutrition on fat-free mass (FFM) and its constituents, such as muscle and organs, and on fat mass (FM) and its regional distribution. Recent studies show that severe-acute undernutrition, categorised as ‘wasting’, is associated wit...more